BSN315 Exam 1 Actual Exam Style V2 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient with liver cirrhosis is prescribed a medication that is primarily metabolized by the
liver. What should the nurse anticipate regarding the medication’s effect?
A. The patient will require a higher dose than normal.
B. The medication will be excreted more rapidly.
C. The medication will have a prolonged half-life and increased risk of toxicity.
D. Absorption of the drug in the GI tract will be significantly increased.
Answer: C
Rationale: Liver cirrhosis reduces the organ’s ability to metabolize drugs, which can lead
to accumulation in the bloodstream. A prolonged half-life means the drug stays active in
the body for a longer duration than intended. Nurses must monitor these patients closely
for signs of toxicity and expect lower dosage requirements.
2. Which pharmacokinetic process is most affected by a patient’s serum albumin levels?
A. Metabolism
B. Distribution
C. Excretion
D. Absorption
,Answer: B
Rationale: Distribution involves the transport of a drug by the bloodstream to its site of
action. Many drugs bind to albumin; if a patient has low albumin, more free drug is
available in the blood, increasing the risk of adverse effects. This is a critical consideration
for malnourished or elderly patients with low protein levels.
3. A nurse is administering a sublingual medication. Which statement by the nurse best
explains the rationale for this route?
A. The drug is absorbed slowly for a steady therapeutic effect.
B. The drug will be neutralized by gastric acid before reaching the liver.
C. Sublingual meds are easier for patients with dysphagia to swallow.
D. This route avoids the first-pass effect in the liver.
Answer: D
Rationale: Sublingual administration allows the medication to be absorbed directly into
the systemic circulation via the mucous membranes under the tongue. This bypasses the
digestive system and the first-pass metabolism by the liver, resulting in faster onset and
higher bioavailability. It is commonly used for medications like nitroglycerin that require
rapid action.
4. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
intervention?
A. Monitor serum drug levels frequently as ordered.
, B. Administer the drug only as needed (PRN).
C. Encourage the patient to increase fluid intake.
D. Assess for changes in the patient’s heart rate only.
Answer: A
Rationale: A narrow therapeutic index indicates that there is a very small margin between
a therapeutic dose and a toxic dose. Frequent monitoring of serum drug levels is necessary
to ensure the patient remains within the safe window. The nurse must also stay alert for
any clinical signs of toxicity regardless of the laboratory values.
5. A nurse is preparing to administer an intramuscular injection to an infant. Which site is
most appropriate for this age group?
A. Deltoid
B. Vastus lateralis
C. Dorsogluteal
D. Ventrogluteal
Answer: B
Rationale: The vastus lateralis is the preferred site for intramuscular injections in infants
because it is the most developed muscle at birth. Other muscles like the deltoid or gluteal
sites are not sufficiently developed and may pose risks to nerves or vessels. Proper site
selection is vital for safe and effective drug delivery in pediatric populations.
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient with liver cirrhosis is prescribed a medication that is primarily metabolized by the
liver. What should the nurse anticipate regarding the medication’s effect?
A. The patient will require a higher dose than normal.
B. The medication will be excreted more rapidly.
C. The medication will have a prolonged half-life and increased risk of toxicity.
D. Absorption of the drug in the GI tract will be significantly increased.
Answer: C
Rationale: Liver cirrhosis reduces the organ’s ability to metabolize drugs, which can lead
to accumulation in the bloodstream. A prolonged half-life means the drug stays active in
the body for a longer duration than intended. Nurses must monitor these patients closely
for signs of toxicity and expect lower dosage requirements.
2. Which pharmacokinetic process is most affected by a patient’s serum albumin levels?
A. Metabolism
B. Distribution
C. Excretion
D. Absorption
,Answer: B
Rationale: Distribution involves the transport of a drug by the bloodstream to its site of
action. Many drugs bind to albumin; if a patient has low albumin, more free drug is
available in the blood, increasing the risk of adverse effects. This is a critical consideration
for malnourished or elderly patients with low protein levels.
3. A nurse is administering a sublingual medication. Which statement by the nurse best
explains the rationale for this route?
A. The drug is absorbed slowly for a steady therapeutic effect.
B. The drug will be neutralized by gastric acid before reaching the liver.
C. Sublingual meds are easier for patients with dysphagia to swallow.
D. This route avoids the first-pass effect in the liver.
Answer: D
Rationale: Sublingual administration allows the medication to be absorbed directly into
the systemic circulation via the mucous membranes under the tongue. This bypasses the
digestive system and the first-pass metabolism by the liver, resulting in faster onset and
higher bioavailability. It is commonly used for medications like nitroglycerin that require
rapid action.
4. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
intervention?
A. Monitor serum drug levels frequently as ordered.
, B. Administer the drug only as needed (PRN).
C. Encourage the patient to increase fluid intake.
D. Assess for changes in the patient’s heart rate only.
Answer: A
Rationale: A narrow therapeutic index indicates that there is a very small margin between
a therapeutic dose and a toxic dose. Frequent monitoring of serum drug levels is necessary
to ensure the patient remains within the safe window. The nurse must also stay alert for
any clinical signs of toxicity regardless of the laboratory values.
5. A nurse is preparing to administer an intramuscular injection to an infant. Which site is
most appropriate for this age group?
A. Deltoid
B. Vastus lateralis
C. Dorsogluteal
D. Ventrogluteal
Answer: B
Rationale: The vastus lateralis is the preferred site for intramuscular injections in infants
because it is the most developed muscle at birth. Other muscles like the deltoid or gluteal
sites are not sufficiently developed and may pose risks to nerves or vessels. Proper site
selection is vital for safe and effective drug delivery in pediatric populations.
